EFTA00622577.pdf

LSJ CONSTRUCTION Subcontractor Payout Project: Mechanical Desal January 11, 2011 Trade: Concrete Formwork Requisition #11 Subcontractor Big Bear Construction, Inc. Insurance ex iration: March 1. 2011 Invoice # Requisition #11 Partial Final Phase # 03-120 X Original Contract Sum: $821,461.00 Change Orders Submitted & Approved: $1,135.00 New Change Orders: $0.00 Total Work Contracted to Date: $822,596.00 Total Work Completed to Date: 100% $822,596.00 Less Retainage: $0.00 Total Payments Made to Date: $781,466.20 Total Current Payment Due: $41,129.80 0 K I Balance to Finish including Retainage: $0.00 Sales Tax Liability: a. Subcontractor/Supplier is liable, explaiiinstall only / tax included in contract b. Non-resident Subcontractor/Supplier Bond Applicable: c. Use Tax to be paid by our company: d. Shipping None Total Outlays for this contract incl. Sales or Use Tax: $822,596.00 JEE approval attached Invoice Attached YES NO YES NO X X Submitted Big Approved by: Ga Signed: Signed: Date: January 11. 2011 Date: .1.3!-Tuary 11 20, 1 Approved by: Emad Approved by: Signed: fpr,Na_Ag Signed: Date: \\ \ Date: EFTA00622577  LSJ CONSTRUCTION Project Mechanical Desat AtbconIracior lull legal name By Bear Conszruceon. Inc Dale Revised January 11.201• Phase 4 03.120 Trade. Concrete Formwork invoice a Requation et I Insurance espiralion 1 Mar•I I Payment Penal Final X 'Avoca/Regis Dale C1O Amount Retainer Due Pad Date Pad °lecke Balance I Contract Amount 0Y11/10 821.461.00 COM 07/12/10 4.83500 C042 12115710 (3,700 00 C043 cots coos Re. ..-ition et 03/31/i0 74 4C0 00 3 720 00 70 680 CO 70 680 Oo 000 I figalin Re. &lion 43 42 RequisAtion 44 NOIMIE C OS 06/31/10 44.475 00 120.700.00 72.025 00 2.223 75 6.035 00 3.601 15 42,251 25 114.665 00 68,423 75 42.251 2r. d,. 114 66500 or 68.423 75 ,, 000 0110 000 RegoiSitton 45 07/21/10 57.32500 2.86625 54,458.75 54.456.75 .." 000 Regarabon #6 08/25,10 115.040 00 5.75200 109,288.00 109.268 00 IL_ 000 Requisition la 09124/10 57.255 00 2.86275 54.392 25 54,392 25 i 000 Requallion 48 10/25710 119.845 00 5.992 25 113852 75 113.852 75 0.80 Bowsaw *79 11124/10 123.920 00 6.19600 117 724 00 117.724 no 000 Requisition 410 12/16110 37.611 00 1.880 55 35,73045 35.730 45 ./ 000 Requisition 011 01711/11 Retainage (41 129 80 41.12980 Total 822,59600 000 622,596 00 781.486.20 41 12980) Contract Amount Phase Contract Ceeciele Foirrneoth 821.46100 COSI Trench soXiOn 4.83500 DOSCTIO0041 con Cistern coaling repair 13100 00) DeSenpliCin C063 Description COS4 Descnolion C045 Deson01.00 Conuacnxi To Dale 822.6%00 Balance of Connect wRela.nago EFTA00622578  APPLICATION AND CERTIFICATION FOR PAYMENT AIR DOCUMENTGTO N IAA APAI l.rYµµl b...• AA VO, AAP,. 04 A IA. Mw TIN ANN -tans • 120 11 likey :Can VACI*I Al illsAitavivAnn of • I1011 *.t t4143 LAP!, Lawn rye“ :08)t TROsett • 110 1 0 CONTRACTORS APPMATION FOR DAYNENT 'he Catnon conk. Al Pee LAY 0t3 Ornalse•irawallP NA0cmcn 0 Ain* Advnem lL 1190i 04104 cor-nto• NtAvz C<ATAN nun/win 414 4/ t. eldo k a.. w 444sitata..0. IA)/p/ %S tar Contnavon STAN 414 Zoc.ortAt G732 4 iTacTea tereW41.14404444 AIN'T Cengi Dawns. OM 4.0/41 44.04 619 0. a, Cosy ito IA.A own•CIAIRC41.04%, P•aal moo And Ad .D4 r, A , A, vend Pie A, 4 O..* ato Ow A.se‘ 441/140141awn ram • VA Oa I Qftalhal CC.STRACTSVU 141 TO CONTRACTOR: 2 Weer birCINATA 0,00 . 51 73333 3 CONTRACT Cutd IODATE0.AT 1 e 21 SAZ2 6S6 3C By GO NAT CA.10 0Cm/AINC OOH la ••201, 4 roma COLRETE06 STOIC to 56125%60 DATE teAtroGynali 6 AllustmTI sum Co" V SOPAt. COnttesed WAN kratteemen Si. 1 2960 AAnttcsi sed isnAT, Y..n re on Aare Ka n0•e or @Mt • .•4t 308% 030:04 1ddloc• SOD, UT ttaiNVO, Kira I on ow*. TyAI RADARia flees So • 10a CERTIFICATE FOR PAYMENT IRAN, Cowin ATI OM, SL11NN 6 TOTAL EARNED LESS RITAINACE ST61.46620 An ILAN tat STARA • LESS ANEMIA Ca TO CATES SOR Ceuta, ▪ ocArrirot wa.v.i.nau Osama mud Tv no am canes++ Aromm:A TI. CAmAtsvm Amnon. 0 4TACIT Oat honor, $ 71 1 10' /0 V4A014, CURRI N MEAN WE S11.120 do W4.0.10.4 tan , ne.~...r. COW4tk. • Ogee SOAWC CfAtif CO • BALANCE TO ANSA NC:LA1hGRE TAINCE 511 1 2903 are A Asa „re A AMOUNT CENTIME° Sat 12950 CHANGE ORDAR SURVART 4030•ONS I OCCUCTIOKS Alm 'aline I 1 1,001C•4100 4,44ribiAte IM•frA119.4weTo 44•4440:0 ot ...4a gm w. TVS 00•00.600 ,140 5' 136 00 I tose0.04 n Ammo ~RS WCAnin I003 CORWIN 100 Ifinerder Toed some TAS W. VOA SO 0 By 0-1:1/2-// TO. 1AS S. WOO SO 0, • • sa, 'OMNI* CIPT 0 eD• stole sak NIA :sinew la ow. Alin* 401.104.40444 e • .4nm. net ate YCrjNW 99.. OIII:crena NET CAANAMS Ay:MAN/ IAN' I SLIM% I • CC.C.Neil it e' Mel CA AIN Ate CIA TM' IA 'ova *CP CA %di k , A • IA AI. p. rui 4.1).114.', ... ,A , 4•1.,C. 0/4 14 MN Obtain .0 1.0.000 eo 01. document by Anau0st4 a C0001•144 AM 0•Nonom 0101 .CmtlIcation a Oocoment's Aka/memory Pam Me License. JAN I I 20I) Sire• I of I EFTA00622579  CONTINUATION SHEET Am DOCUMENT 0703 An Document 6702. APPLICATION AND CERTIFICAT ION FOR PAYMENT coniamag APPLICATION NO. 11 Contractor's signed cortScation is arached APPLICATION DATE 01/11/11 In labuLINOn$ below. amounts art statue 10 tImt nearest dollar PERIOD TO 01/11/11 Use Column Ion Contracts where variable retainage Iv hat COM; Ma apply A B C D a E 0 N i ITEM CESCRPTION SCHEDULED WORK COMPLETED MATERIALS rcrk, 5. CALONCE RETANAGE 40 CF WORN VALUE FROM PREVIOUS THIS PRESENTLY COMPLETED (G • Ci ro FINISH la VARMSLE APPLICATION PEROD STORED AND STORED IC • G1 RATE, tO • Et t7r07 IN Dila) TO DATE 0 ORE) 10.641 00001 Shourg Rental $68350.00 S68.350 00 50.00 5000 $68.35000 10000% $0 00 3417.50 00002 Ties WM ACCeSSOPOS $28500.00 628 500 00 50.00 5000 528.500 00 100 CO% S0.00 1125 03 00003 Form Regal 523.500 03 523.500.00 50 00 $0 00 523.50000 10000% $0.00 1175.00 00004 Insurance $8.500.03 $8.500.00 $0 00 SO CO 18.50300 103.00% 50.00 425.03 00005 Fregnt 519.500.03 $19.930.00 $0 00 50.00 519.50000 10000% 5000 975.03 00008 Forming materials $500000 55.000 00 5000 $0.00 55.00000 100.00% 50 00 250.00 00007 Ms: Materials 510000.00 $10.03000 50 00 50.00 510.000 CO 10300% 50 00 500.00 00008 Mem Site Work 530 750 00 530.75000 50 00 5 5 0 00 530.750.00 1(000% 50.00 1537.50 00009 Base Stab Form 516 70000 $16.700.03 $0 00 5000 516.70000 '0300% 50 00 835 00 00010 Base Slat Reader/On 534000.00 534.000.00 $000 50.00 $34.000.00 100 00% $000 1740.00 00011 Base Slat Pout 55 950 DO 55.950 OD $0 00 $0 00 55.950 CO '0000% $0.00 297.50 00012 Base Wats Form $56.300.00 $56.300.00 $0 00 50.00 $56.30000 10000% $0.00 281500 00013 Oast Wilt Rein/196812 $32 700.03 $32.700.00 $O 00 $0.00 532.700 CO 10000% $0.00 1635 00 00014 Basewatc Pour 56.30000 56.300 00 5000 50.00 58.30000 '0000% $0.00 31500 00015 1st Elevates Slab Form $4195000 541.95000 SO 00 $0 00 $41.950.00 10000% 50.00 2097.50 00016 1SI EPPrelee Slab Reirkircos $37 250.00 537.250.00 $0 .00 $0.00 537.250 CO 100 00% 50 00 1862 50 00017 1st Elevateo Slab Pour $5.400.00 58.400.00 50.00 50.00 56.403 00 103 00% 50.00 ' 420.00 00018 1st FT. Was For. $79 000 00 $7900000 $0 00 50.00 57903000 '00 00% 50.00 395000 00019 1s1F1 Was Reeforcirop $41700.00 541700.00 50.00 50.00 $41.70000 10000% 50.00 2085.00 00020 ist Ft. Was Pax 55 800 00 55.600.00 50 00 50.00 55.600 00 109.00% 50 00 280 CO 00021 Root Slab Form 554.650 X 554.650 03 S000 56.00 554.650130 100.00% 50.00 2732 50 00022 Rod Stab Reinforcing $4250000 542.500.00 50 00 $0.00 542.50000 10000% S0.00, 2125 00 00023 Root Slab Par 59.10000 $9.10000 $0 00 50.00 59.10000 10000% 50.00 455 00 00024 Parapet Will Form Si 1.450 X 511.45000 50 00 $0.00 $11,45000 100.00% 50.00 572 50 0002.5 Parapet Wall Reeitorcog 52 800 00 $280000 50 00 50 00 52.80003 103.00% 50.00 140 00 00026 Palatal Wall Pouf $3.300.00 $3.300.00 SO 00 SO 00 $3.300 00 100 00% 50 00 165 00 00027 Overhead $34228.00 534 228.00 50 00 SO CC 534,22800 100.03% 5000 1711.40 00028 Proca 5102.683.00 5102.683.00 50 00 50 00 5102.68300 100.00% 50.03 5134 15 00029 CC)" Trench StsoonNB Credit 5483500 5483500 50 00 50 00 $4,83500 10300% 50 00 2417$ 00030 C042PNip 141.* BEL:84W (53 700 0)) i$3 700 00' 50 00 5000 iS3 700 0:4 10000% 50 00 -185.00 00031 5000 5000 50 00 50 00 40N00' 5000 0.00 00032 50.00 50 CO 50.00 SO CO 401VrOr 50.00 000 GRAND TOTALS 5822 596 30 5822 596 CO 50 00 5000 5822,596 00 leo 005/ 50 00 541 129 BC EFTA00622580 Emad Hanna From: Eve Febe Sent: Tuesday, Jam l iwyrt l :0 8. To: Emad Hanna Cc: Monique Harry Subject: Big Bear Construction, Inc Req. k11 1010 Attachments: Big Bear Construction , Inc Req. #11.pdf Good Afternoon Emad, Attachment for payment Big Bear Construction, Inc Req. #11. In the amount of $41,129.80. Project 1010 Code 03-120. Eve EFTA00622581